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      Efficacy of second-trimester termination procedure; medical, mechanic, or combine?


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          During mid-trimester, it is necessary to terminate pregnancy due to some fetal anomalies and intrauterine death. Therefore, in this study, we aimed to compare abortion induction methods and combined use retrospectively.


          About 112 out of 223 pregnant patients were included in the study. The groups were determined as follows: Group 1 including pregnant patients who were administered misoprostol only (50 patients), Group 2 including pregnant patients who were administered single dose misoprostol (according to FIGO) and subsequently received cervical Foley catheter (30 patients), and Group 3 including pregnant patients who received Foley catheter only (32 patients). These three groups were compared in terms of effectiveness of the method, side effects, and complications as well as their characteristics.


          In terms of characteristic of the groups, the average age of the women in the Group 1 was significantly higher than other two groups ( p < 0.001). In terms of effectiveness of the method, the termination period in Groups 1 and 2 was significantly lower than Group 3 ( p < 0.001). However, in terms of complications, it was observed that uterine rupture was developed in Group 1.


          Although medical methods may seem to be more effective in the process of termination, mechanical methods seem more reliable in terms of reliability. Especially combined methods can be used to increase effectiveness and also to reduce complications.

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            Risk factors associated with presenting for abortion in the second trimester.

            To determine factors associated with delay of induced abortion into the second trimester of pregnancy. Using audio computer-assisted self-interviewing, 398 women from 5 to 23 weeks of gestation at an urban hospital described steps and reasons that could have led to a delayed abortion. Multivariable logistic regression identified independent contributors to delay. Half of the 70-day difference between the average gestational durations in first- and second-trimester abortions is due to later suspicion of pregnancy and administration of a pregnancy test. Delays in suspecting and testing for pregnancy cumulatively caused 58% of second-trimester patients to miss the opportunity to have a first-trimester abortion. Women presenting in the second trimester experienced more delaying factors (3.2 versus 2.0, P < .001), with logistical delays occurring more frequently for these women (63.3% versus 30.4%, P < .001). Factors associated with second-trimester abortion in logistic regression were prior second-trimester abortion, delay in obtaining state insurance, difficulty locating a provider, initial referral elsewhere, and uncertainty about last menstrual period. Factors associated with decreased likelihood of second-trimester abortion were presence of nausea or vomiting, prior abortion, and contraception use. Abortion delay results from myriad factors, many of them logistical, such as inappropriate or delayed referrals and delays in obtaining public insurance. Public health interventions could promote earlier recognition of pregnancy, more timely referrals, more easily obtainable public funding, and improved abortion access for indigent women. However, accessible second-trimester abortion services will remain necessary for the women who present late due to delayed recognition of and testing for pregnancy. II-2.
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              FIGO's updated recommendations for misoprostol used alone in gynecology and obstetrics


                Author and article information

                Interventional Medicine and Applied Science
                Akadémiai Kiadó (Budapest )
                25 July 2018
                September 2018
                : 10
                : 3
                : 133-136
                [ 1 ]Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara University , Ankara, Turkey
                Author notes
                [* ]Corresponding author: Tuncay Yüce; Ankara Universitesi Tıp Fakültesi, Cebeci Hastanesi Kadın Hastalıkları ve Doğum AD, Mamak, Ankara 06590, Turkey; Phone: +90 505 594 35 21; Fax: +90 312 320 35 53; E-mail: drtuncayyuce@ 123456gmail.com
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                : 26 July 2017
                : 19 April 2018
                : 02 May 2018
                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 16, Pages: 4
                Funding sources: None.
                ORIGINAL PAPER

                Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
                Foley catheter,complications,second trimester,termination,misoprostol


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